Difficulties in Diagnosing Volumetric Formations of the Spleen: an Example of a Clinical Case

Differential diagnosis of bulk splenic neoplasms, despite proper visualization in ultrasound, computed tomography and magnetic resonance imaging of the abdominal cavity, is challenging due to the lack of a unified classification, the extremely rare occurrence of some tumors and difficulty of preoperative morphological identification. The paper discusses a case of making an erroneous preoperative diagnosis in a spleen mass: the instrumental study findings determined the presence of multiple cysts. The latter among all the neoplasms of this organ are the most common and are represented by a variety of forms, subdivided by origin, histogenesis and content features. According to some classifications, cysts are classified as tumors or tumor-like diseases, other sources classify them as non-tumor formations of the spleen. It is not often possible to fully exclude the parasitic origin of the cyst before the morphological study of the removed organ. Surgeons of the Voronezh Regional Clinical Hospital No. 1 encountered this problem during the treatment of a 34-year-old patient with the spleen neoplasm. A diagnosis of lymphangioma was made based on surgical treatment and pathomorphological findings. The analysis of this clinical case demonstrates relevance of splenectomy both as a method of final diagnosis and as the final stage of treatment for benign tumors; it allows avoiding misdiagnosis in case of a malignant tumor.